| NPI | 1891764577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ME 010885) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: ME 010885) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2011-03-03 |